慢性肾脏病5期患者炎性反应与营养不良的临床观察

目的探讨慢性肾脏病（CKD）5期患者机体炎性反应和营养状态的变化及其相互关系。方法90例CKD5期患者分为非透析（ND）组、血液透析（MHD）组和腹膜透析（CAPD）组，每组各30例，检测其炎性反应指标血浆高敏c反应蛋白（hs-CRP）和营养指标（血浆白蛋白、血红蛋白），并与30例健康体检者（健康对照组）进行比较。结果CKD5期患者血浆hs-CRP水平高于健康对照组（P〈0．01），MHD组和CAPD组患者血浆hs—CRP水平均高于ND组（P〈0．05），MHD组与CAPD组患者血浆hs—CRP水平比较差异无统计学意义。血浆白蛋白〈35g／L和血红蛋白〈90g／L的CKD5期患者血浆hs—CRP增高更为明显，且血浆hs-CRP水平与血浆白蛋白和血红蛋白呈负相关（r=-0．535，P〈0．01；r=-0．220，P〈0．05）。结论CKD5期患者血浆hs．CRP水平增高，且与血浆白蛋白和血红蛋白之间存在负相关，炎性反应可能是导致或加重CKD患者营养不良的原因之一。

Clinical observation of inflammation and malnutrition in patients with stage V chronic kidney disease

Objective To explore the variation of the plasma high-sensitive C reactive protein （hs-CRP） levels and analyze the relationship between inflammation and malnutrition in the patients with stage V chronic kidney disease （CKD）. Methods Ninety patients with stage V CKD were enrolled. The patients were divided into three groups according to their treatment, no dialysis （ND） group, hemodialysis （MHD） group and continuous ambulatory peritoneal dialysis （CAPD） group. Plasma hs-CRP, albumin and hemoglobin were detected. Results The levels of plasma hs-CRP were significantly increased in the patients with stage V CKD compared with normal individuals （P 〈 0.01 ）. It showed a significant difference between MHD group, CAPD group and ND group （P 〈 0.05 ）, while no significant difference was found between MHD group and CAPD group. The plasma hs-CRP levels increased in the patients with lower plasma albumin （ 〈 35 g/L） or lower hemoglobin （ 〈 90 g/L）. Levels of plasma hs-CRP showed a negative relationship with plasma albumin and hemoglobin （r =- 0.535, P 〈 0.01 ;r =-0.220, P 〈 0.05）. Conclusions Plasma hs-CRP levels increase in patients with stage V CKD, and there is a negative relationship between hs-CRP and plasma albumin and hemoglobin. Inflammation may be a factor of malnutrition in patients with CKD.